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Spontaneous Intracranial Hypotension: A Case Report

自發性低顱內壓引發嚴重頭痛:病例報告

摘要


自發性顱內低壓是一種具有獨特表現的頭痛病徵,但是在急診仍常常被誤診。一位沒有先前頭痛病史的22歲男性,因爲嚴重的姿勢性頭痛於外院就診多次無效,而到本院急診就診。腰椎穿刺檢查發現異常低的腦脊液壓。放射線同位素的腦池攝影檢查證實了腦脊液在胸椎的位置有明顯的外漏。我們以保守性治療成功的治癒他的頭痛且無留下任何後遺症:自發性顱內低壓是近幾年常被提起造成頭痛的原因,我們回顧最近有關自發性顱內低壓的文獻,並且提醒急診醫師需將自發性顱內低壓列為頭痛的鑑別診斷之一。

並列摘要


Spontaneous intracranial hypotension (SIH) is a distinct form of headache that is often misdiagnosed in general practice. We describe a case of SIH in a 22-year-old man without any previous history of headaches. He presented at the Emergency Department with a typical orthostatic headache secondary to intracranial hypotension and low cerebrospinal fluid (CSF) pressure. Radioisotope cisternography confirmed a CSF leakage in the thoracic spine area. The patient was treated conservatively and recovered without sequelae. SIH is an increasingly recognized cause of headache. We review recent literature and remind emergency physicians that SIH should he included on the headache differential diagnosis list.

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